| NPI | 1386262145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS043516) |
| Additional Taxonomies | 122300000X Dentist (Licence: CO DEN.00204451) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2022-06-22 |